A National Action Agenda: Eliminating Health Disparities
 

Admiral John O. Agwunobi, M.D., M.B.A., M.P.H.
Assistant Secretary for Health
U.S. Department of Health and Human Services

To many in the health arena, minority health and health disparities are often referred to interchangeably.  In our diverse nation, it is to be expected that there will be some differences between us.  However, it is wrong when those differences lead to inequalities in health. 

Most Americans believe that disparities in health care should not exist.  The reality is that health disparities actually pervade our country.  In fact, 68 percent of Americans are unaware of the disparities between racial and ethnic minorities and the rest of the population. 

The old adage that “what you don’t know won’t hurt you” does not apply to health disparities.  Every year thousands of human lives are lost prematurely, millions of dollars are wasted, businesses lose employees, families lose loved ones and communities lose leaders.  We all lose when Americans don’t have access to appropriate health care and when there are disparities in health outcomes. 

The question is: how do we improve minority health and eliminate health disparities?  In 1985, former Health and Human Services (HHS) Secretary Margaret Heckler led the way when she issued the landmark Report on Black and Minority Health.  This eight-volume study helped to bring minority health disparities to the forefront of the health agenda.  It also led to the development of the HHS Office of Minority Health, sparked more robust data collection, and inspired the creation of minority health funding and programs across HHS. 

As a result, we have seen positive results in minority health over the past 20 years.  More minority women are receiving early prenatal care; adult and childhood immunization rates among racial and ethnic minorities are improving; and death rates for heart disease, stroke, influenza, and pneumonia (age adjusted) for American Indian/ Alaska Native, Asian American/Pacific Islander, African American, and Latino communities are decreasing.

We should celebrate these accomplishments.  The leaders who came before us paved the way for a healthier nation for all Americans.  As we think about what our contribution will be to this legacy of leadership and reflect on the tremendous progress, we must also review the challenges that still exist.

Perhaps the first step is to acknowledge that there are stark differences in health outcomes among racial and ethnic groups in America.  Put simply, minorities are dying at higher rates when compared to white Americans.  In 2003, life expectancy at birth for African American males was 69.  That was the death rate for white males in 1974, more than 30 years ago.  Racial and ethnic minorities are also less likely to get or have access to preventative health services.  Latinos have the lowest rates of health insurance and regular sources of health care and are actually experiencing an overall increase in health disparities.

HHS Secretary Michael Leavitt and I are deeply committed to eliminating health disparities.  We are working to create a health care system that moves us toward a nation that promotes prevention and one where all Americans have equitable opportunities for attaining optimal health, regardless of race or geography.

We believe that to truly eliminate health disparities we must create awareness about disparities within our nation.  We must awaken the nation to the realities of health disparities.  We are working to move the agenda of eliminating health disparities beyond that of a minority issue, because it is truly a national issue that requires a comprehensive national response.  Everyone has a role to play.

HHS is taking this mission to heart.  In January 2006, we called on 2,000 leaders across the country to join us in a National Leadership Summit on Eliminating Racial and Ethnic Disparities in Health.  We listened, we collaborated, and as a result, we are working on a National Action Agenda that will tour the country seeking community solutions to health disparities.

We are also taking steps to improve access to quality care through the expansion of community health centers; implementation of the new Medicare prescription drug benefit; and exploration of health information technology as a tool to help reduce errors, monitor health, and prompt health care professionals to ensure that education is a part of every health care visit.

We have learned an important lesson over the past 20 years: government cannot do this work alone.  We will continue to need guidance, support and partnership from all sectors of society.  We all have a role to play in eliminating health disparities – whether at the individual, community, state, or national level.  Working together, we can and will eliminate racial and ethnic health disparities for all Americans.

For more information, visit the HHS Office of Minority Health web site at http://www.omhrc.gov/ or call 1-800-444-6472.

References:

National Center for Health Statistics, Health, United States, 2005.  Hyattsville, Maryland.  Public Health Service. 2005.Centers for Disease Control and Prevention.  Disparities in Screening for and Awareness of High Blood Cholesterol – United States, 1999-2002.  MMWR. 2005; 54(05); 117-119.

Centers for Disease Control and Prevention.  Racial/ Ethnic and Socioeconomic Disparities in Multiple Risk Factors for Heart Disease and Stroke - United States, 2003. MMWR. 2005; 54(05); 113-117.

Arias, E. United States Life Tables, 2003.  National Center for Health Statistics.  Vital Health Statistics Series No. 14 (54). 2006.

Harvard University School of Public Health and the Robert Wood Johnson Foundation.  Americans’ Views of Disparities in Health Care.  December 2005.